JAMA article points to pharmacy’s role in MTM, improved patient care system

By Jim Frederick

ALEXANDRIA, Va. The drumbeat in support of an expanded, universally recognized role for pharmacists in helping patients successfully manage their drug therapy is getting steadily louder.

The latest note of support comes from the chief voice of the nation’s physician community, the Journal of the American Medical Association. In an Oct. 13 article, JAMA points to community pharmacists as a key resource to help bridge the gap between doctor and patient, particularly for patients treated by more than one specialist in an often disconnected and dysfunctional health care network.

The article, titled “Medication Use in Older Patients: Better Policy Could Encourage Better Practice,” was hailed by the National Association of Chain Drug Stores Thursday as “further validation of the need for public policy to embrace pharmacists’ expertise in helping patients take their medications correctly.” What’s more, notes the group, the points made by JAMA author Jerry Avorn, MD, are “consistent with NACDS’ ongoing campaign to raise awareness of … medication adherence to help boost health and reduce healthcare costs.”

Avorn highlights both the critical value of drug therapy and the need for accessible, community-based health professionals, such as pharmacists and nurses, to augment a more effective, patient-centric health system. “The use of medications in older patients,” he wrote, “is arguably the single most important health care intervention in the industrialized world.” However, he noted that “dys-organization” in healthcare delivery is “particularly problematic for complex patients with several chronic conditions who take multiple medications, often provided by numerous specialists in little or no contact with one another — a recipe for pharmacological chaos.”

Avorn “specifically mentions pharmacists as a solution,” NACDS pointed out. “Although the 2010 healthcare legislation did not reform the delivery system, it did provide for small pilot studies of ‘medical homes’ that could address the fragmentation of care that so often defeats the provision of integrated, coherent drug regimens for elderly patients with complex health care needs,” the author writes. “Solutions could be designed-in as these systems develop in several ways. Pharmacists and nurses could work with physicians to develop, implement, and monitor drug regimens.”

NACDS president and CEO Steven Anderson found plenty to like with that approach. “NACDS is 100-percent committed to unleashing the power of pharmacy to help improve lives and to reduce the estimated $290 billion in annual costs — 13% of all healthcare expenditures — related to not taking medications correctly,” he said. “This effort is resulting in consistent progress, such as the advancement of pharmacist-provided medication therapy management that provides a methodical approach to increasing medication adherence.”

To that end, noted Anderson, “The article in the Journal of the American Medical Association is yet another drumbeat that should continue to inspire action for further progress in public policy.”